Gall Bladder Cancer is the uncontrolled growth and division of the cells of the gall bladder - the small, pear-shaped organ located on the right part of the abdomen, just beneath the liver.
The gall bladder stores bile produced by the liver, which breaks down and digests the fats present in the food when they pass through the small intestine.
If diagnosed in the initial stages, the chances of curing gall bladder cancer i.e. by removing the gallbladder, part of the liver and associated lymph nodes are much higher. But since the symptoms of cancer crop up much later and get discovered at a later stage, there are bleak chances of the total recovery.
There are no exact causes of gall bladder cancer but some risk factors that might contribute include formation of gall stones, cholecystitis, porcelain gallbladder and chronic gall bladder infection. This type of cancer increases with age and is mostly found in women than in men. Several kinds of research conclude that obese people at the higher risks of having this type of cancer.
It is difficult to diagnose gall bladder cancers during a normal physical examination as they don’t show up in the earlier stages or there are very mild symptoms or no symptoms at all. Also, as the organ is partially covered by the stomach, the spreading happens metastatic and goes unnoticed. Gall bladder cancers are mostly adenocarcinomas which means they very easily spread to the neighbouring organs.
There are several types of gall bladder cancers depending upon the type of cell lining the outer surface. Some of them are:
1. Adenocarcinoma
The most common type of gall bladder cancer which starts in the gland cells lining the gall bladder.
This type is further subdivided into:
Non-papillary adenocarcinoma
Papillary adenocarcinoma
Mucinous adenocarcinoma
2. Adenosquamous Cancer
This type of gall bladder cancer have both squamous cancer cells and glandular cancer cells
3. Small Cell Cancer
They are named as oat cell carcinoma as the cells have the shape of oats.
4. Sarcoma
It is a type of gall bladder cancer that affects the supportive or connective tissues of the body i.e. blood vessels, nerves and muscles.
5. Neuroendocrine Tumour
This type of cancer grows inside the G.I tract on the influence of some hormone produced inside the tissues.
6. Lymphoma and Melanoma
Rare type of gall bladder cancer where the treatment procedure is different than the rest of the other types.
7. Squamous Cell Cancer
It happens in the square-like outer skin cells lining the gall bladder.
Symptoms
Although it is arduous to detect, some of the signs and symptoms we should properly heed are:
- Abdominal pain and cramping mostly on the upper right side of the abdomen
- Abdominal bloating
- Nausea
- Sudden loss of body weight
- Fever
- Jaundice
- Itchiness
- Aversion to food
Diagnosis and Treatment
The diagnosis is usually done by a gastroenterologist after properly knowing the patient’s past medical history and running some diagnostic test which includes:
- Blood Test – To evaluate the liver function
- Imaging techniques - Ultrasound, MRI- Scan, CT-Scan
After a thorough diagnosis, the cancer is staged to understand the extent of spreading. Tests include:
- Biopsy
- Exploratory Surgery
- Imaging Tests: CT of the chest and abdomen, ultrasonography and MRI of the liver and positron emission tomography
- Exploratory Surgery Tests to Examine the Bile Ducts: Magnetic resonance cholangiography (MRC), Endoscopic retrograde cholangiopancreatography (ERCP) and Percutaneous transhepatic cholangiography
The treatment options are different depending upon the extent of spreading and the stage of cancer so as to promote overall health with the least possible side effects.
Early Stage Gall Bladder Cancer:
Surgery is the most availed option opted in the initial stages to remove spreading from the roots. Procedures include:
- Surgery to remove just the gall bladder
- Surgery to remove the gall bladder and a portion of the liver
It is unsure whether cancer may return after surgery or total removal of the gland, hence doctors may suggest chemotherapy and radiotherapy following the surgical procedures.
Late Stage Gall Bladder Cancer:
In the later stages, surgical options may not cure cancer. Hence, the doctor selects specific treatments and procedures to reduce the pain and keep the patient comfortable. These include:
- Chemotherapy
- Radiotherapy
- Clinical Trials
- Procedure to remove the blockage of bile ducts